Recreational Nitrous Oxide Abuse-Induced Vitamin B12 Deficiency in a Patient Presenting with Hyperpigmentation of the Skin

@article{Chiang2013RecreationalNO,
  title={Recreational Nitrous Oxide Abuse-Induced Vitamin B12 Deficiency in a Patient Presenting with Hyperpigmentation of the Skin},
  author={Tsung-Ta Chiang and Chih-Tsung Hung and Wei-Ming Wang and Jiunn‐Tay Lee and Fu-Chi Yang},
  journal={Case Reports in Dermatology},
  year={2013},
  volume={5},
  pages={186 - 191}
}
Vitamin B12 deficiency causes skin hyperpigmentation, subacute combined degeneration of the spinal cord, and megaloblastic anemia. [...] Key Method Here, we describe the case of a 29-year-old woman presenting with skin hyperpigmentation as her only initial symptom after N2O abuse for approximately 2 years.Expand
Vitamin B12 deficiency-induced neuropathy secondary to prolonged recreational use of nitrous oxide.
TLDR
Emergency Medicine (EM) physicians should be aware of this condition because NO2 is used both recreationally and in medicine and the toxic effects can be profound and mimic other emergent conditions like stroke. Expand
Skin hyperpigmentation: a rare presenting symptom of nitrous oxide abuse
TLDR
Skin hyperpigmentation is a rare symptom in N2O abusers, which can distribute locally in hands or diffusely throughout the body, and attention should be paid to a history of N 2O abuse and serum vitamin B12 level should be tested. Expand
Inhaled nitrous oxide-induced functional B12 deficiency
TLDR
A 19-year-old man presented to the emergency department with a 4-week history of worsening paraesthesia in his fingers and lower limbs, and weakness in the hands and lower limb for 2 weeks, and an MRI brain and spine revealed myelopathy of the cervical and thoracic cord. Expand
Subacute Combined Degeneration of the Dorsal Columns in A Patient With Nitrous Oxide Induced B12 Inactivation: A Case Report
TLDR
A case of a 28 year old patient who abused N2O, then went on to develop neurologic symptoms of ataxia, numbness and subacute combined degeneration of the dorsal columns as seen on MRI, whose symptoms were consistent with vitamin B12 deficiency despite having normal vitamin B 12 levels by conventional lab measurements. Expand
Recreational Nitrous Oxide Abuse: Prevalence, Neurotoxicity, and Treatment
  • Yuanyuan Xiang, Lei Li, +5 authors Junwei Wu
  • Medicine
  • Neurotoxicity research
  • 2021
TLDR
The epidemiology of N 2 O abuse, neurotoxicity mechanisms, clinical manifestations, relevant auxiliary examinations, treatments, and prognosis are discussed to improve social awareness of N 1 O exposure risk, especially among users and clinicians. Expand
Imaging appearance of myelopathy secondary to nitrous oxide abuse: a case report and review of the literature
TLDR
The onset of the disease was usually subacute, the majority of patients were young men, and there was no definite relationship between myelopathy and the amount or duration of N2O inhalation. Expand
One month of nitrous oxide abuse causing acute vitamin B 12 deficiency with severe neuropsychiatric symptoms
TLDR
A 21-year-old university student studying abroad in the USA presented to the emergency department with double vision, lower extremity weakness with difficulty ambulating and other neuropsychiatric symptoms and was discharged on vitamin B12 supplementation. Expand
Recreational nitrous oxide-associated neurotoxicity
A previously healthy 21-year-old woman presented with subacute onset of confusion and gait ataxia. She reported habitual inhalation of nitrous oxide (N2O) purchased online over the past year, withExpand
Venous thrombosis after nitrous oxide abuse, a case report
TLDR
This case represents the first reported patient with a venous thrombus associated with nitrous oxide abuse, and homocysteine and methylmalonic acid levels normalized after cessation ofNitrous oxide use, with no recurrence of venousThrombosis. Expand
Cerebral venous sinus thrombosis: a complication of nitrous oxide abuse
Nitrous oxide (NO) is an inhalant that has become increasingly popular as a recreational drug. While it is presumed to be harmless, a number of adverse effects of NO have been described. We discussExpand
...
1
2
3
...

References

SHOWING 1-10 OF 24 REFERENCES
Severe myeloneuropathy from acute high-dose nitrous oxide (N2O) abuse.
TLDR
This case demonstrates myeloneuropathic changes secondary to acute high-dose nitrous oxide exposure as demonstrated by a 24-year-old man complaining of numbness and tingling of his hands and feet. Expand
Epidermal changes in vitamin B 12 deficiency.
TLDR
Epidermal cells in areas of pigmentation were found to have abnormally large nuclei similar to those previously described in the mucosal epithelium of patients with vitamin B 12 deficiency, supporting the assumption that these enlarged nuclei were indicative of the deficiency. Expand
Cobalamins and nitrous oxide: a review.
The anaesthetic gas, nitrous oxide (N20), once regarded as chemically inert, oxidises some forms of vitamin B12. It does this both when used clinically and in the test tube, and the action isExpand
Clinical aspects of the interaction between nitrous oxide and vitamin B12.
  • J. Nunn
  • Medicine
  • British journal of anaesthesia
  • 1987
TLDR
There was thus a parallel with megaloblastic anaemia and a working hypothesis for the agranulocytosis and the teratogenesis which had previously been observed as toxic effects of nitrous oxide. Expand
Nitrous oxide use in first-year students at Auckland University
TLDR
Although this study does not accurately reflect use of this substance in the wider community, the high prevalence suggests that presentations of subacute myelopathy in an otherwise fit young person should prompt an enquiry about use of N2O. Expand
Clinical and laboratory features and response to treatment in patients presenting with vitamin B12 deficiency-related neurological syndromes.
TLDR
A high index of suspicion of B12def is required in patients presenting with myelopathy, cognitive decline, or neuropathy; therefore, other tests such as bone marrow smear and serum vitamin B12 assay are essential, as the condition is often reversible with treatment. Expand
Hyperpigmentation of Skin
TLDR
This paper describes some of cases and the investigations undertaken to establish the aetiology of the pigmentation associated with vitamin-B12 deficiency in subjects with tropical sprue and tropical megaloblastic anaemia. Expand
Neuropathy following abuse of nitrous oxide
TLDR
A disabling peripheral neuropathy developed in three health workers who habitually abused nitrous oxide, with patterns of numbness that were radicular rather than purely distal, and a “reverse” Lhermitte sign, in the absence of signs of spinal cord involvement. Expand
Clinical practice. Vitamin B12 deficiency.
  • S. Stabler
  • Medicine
  • The New England journal of medicine
  • 2013
Vitamin B12 deficiency causes reversible megaloblastic anemia, demyelinating disease, or both. Current assays have insufficient sensitivity and specificity; methylmalonic acid levels are useful toExpand
Folate/vitamin B12 inter-relationships.
Folate deficiency causes anaemia owing to impaired purine and pyrimidine biosynthesis. Vitamin B12 deficiency causes an identical anaemia owing to metabolic trapping of intracellular folate. VitaminExpand
...
1
2
3
...